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Pregnancy Bliss | Reproductive Health Hub

‘Reduced’ fluid volume in late pregnancy

Question:  Gestational Age 35 Weeks 5 days LMP Liquor amnii is slightly less for gestational age, Amniotic volume index is 8.4 Weight is 2204 gms. R. (India)

Please advise

Answer: At between 35 and 36 weeks gestation, the average weight of the baby is between 2.3 to 2.6kg. This would therefore suggest that the estimated fetal weight in this case is slight low. However, it is still within the normal range, that is, above the so-called 5th centile for the gestation. Technically, it cannot be labelled as growth restriction. You should also remembre an almost 15% margin of error so scan results have got to be interpreted with caution.

Amnitic fluid index (AFI) is also still within the normal range. The lowest acceptable AFI at 35 weeks is 7.9 (this is the 5th centile), it is slightly lower at 7.7 at 36 completed weeks. You can therefore see that we cannot legitimately label these findings as oligohydramnios. If there are no clinical signs to suggest compromised well-being, I would only suggest keeping an eye on pregnancy progress. This may include a repeat 2scan two weeks from the last one, probably combined with weekly cardiotocographic (CTG) monitoring. If there are other clinical features causing concern, a weekly scan to monitor liquor volume and umbilical artery doppler may be of added value.

Swine flu vaccine and breastfeeding

Question:  I'm taking my 3 year old son for the H1N1 vaccination tomorrow (recommended by our GP as he's asthmatic) and I thought it was probably a good idea for me to do it too since I'll be going back to work after Christmas when my maternity leave finishes *sob*. Is the vaccination safe with breastfeeding mothers? My baby boy is just 4 months - would the medication pass into the milk? Would it therefore protect my baby too? E.S. (Greece)

Answer: For obvious reasons, there are gaps in our understanding of effectiveness of this vaccine in various scenarios. This is one of them. However, extrapolating from what is known from experience with similar vaccines employed against related viruses, there is unanimous agreement about its safety for babies. It is. The vaccine does not use a live virus and there is absolutely no risk of the baby being adversely affected. Antibodies produced in the mother’s body following vaccination will be passed through breast milk to the baby. However, it is quite doubtful that these will be in anywhere near enough quantities to offer effective protection. However, remember, the person in closest contact with an infant is the mother and with your being vaccinated, you significantly reduce your risk of catching the infection and therefore passing onto the baby. Your little boy will be eligible for vaccination in a couple of months.

Due date changed following a scan!

Question:  I had my last period on 15th July. Earlier I had PCOD and my periods were not regular. Anyhow I found out that I'm pregnant on September 15th. So did a scan and verified that I'm 7 weeks and 2 days pregnant and my due date is on 21st April next year. On 10th December when I did the next scan, they told me that the scan shows that the due date is on 14th May 2010. Can this be possible? They asked me to come for another scan on 24th December 2009 and I'm really frighten that my baby is not grown well. Can someone advice me on this? I really don’t like to wait till 24th to find out this. Please... M.P. (Sri Lanka)

Answer: I am just as confused as you are. Your doctors are the only people who can explain this shift as, to be perfectly honest, I cannot. Your due date has been moved forward more than three weeks. This cannot be explained by a possible error with the earlier scan. Were we to assume this scan is correct, it will mean the scan you had in September had over-estimated your gestation by more than 3 weeks! That will put your gestation then at 4 weeks. That is simply not possible. For one thing, a scan performed at 4 weeks gestation will not show anything in the uterus. Secondly, scans in the first trimester are by far the most accurate in estimating gestation. You have now gone for a scan almost 12 weeks after that first scan expecting to be 19-20 weeks only to be told you are 17 weeks? This to me defies logic. I hope you will have an opportunity to sit down with your doctors for them to explain this because your concerns are legitimate. I hope it all turns out well in the end. My best wishes.

Amniotic band

Question:  What is amniotic banc? L.C. (USA)

Answer: I do suspect that your doctor’s handwriting may have misled you! My guess is that the doctor meant to write ‘amniotic band’. If my guess is correct then I can briefly explain what that means. Amniotic bands are in reality thread-like bits of the amniotic membrane seen on pregnancy ultrasound scan. It is thought that the inner layer of the gestational sac (called the ‘amnion’) can sometimes get disrupted thereby tearing, the result of which is these strands which can be seen floating in the sac. In very rare circumstances they can wrap themselves around a limb or digit of the fetus with potential major complications. This is very rare.

Pregnancy test positive, then negative

Question:  A couple of weeks go i took a pregnancy test early in the morning because i was going trough all the pregnancy symptoms and it came out positive. A couple of days later i started spotting and then looked like my regular period but shorter n not as heavy. What does that mean? Is it normal because while i was going through that i went to a clinic and got another test that came out negative but it was during the day (not as early as the other one). K. (USA)

Answer: In your details, there is one glaring omission: Was your period late or did you miss one? It sounds to me that yours may have been a false positive result. With modern pregnancy test kits, the sensitivity is such that the timing of the collection of the urine sample doesn’t really matter. An alternative explanation is that you may have had a pregnancy that failed very early and the bleed was miscarriage taking place. However, I find this rather implausible because the test is unlikely to revert to negative so quickly even after a miscarriage. Also, vaginal bleeding that occurs with a miscarriage tends to be significantly heavier than a normal period, the opposite of what you are describing here.